GAMBARAN KARAKTERISTIK PASIEN WOUND DEHISCENCE MENURUT VARIABEL ROTTERDAM DI RSUD KOTA BANDUNG
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ABSTRAK
Wound dehiscence merupakan komplikasi pasca bedah abdomen yang serius dengan tingkat mortalitas dan morbiditas yang tinggi yaitu 3-35%. Insiden wound dehiscence di dunia sekitar 0,4 - 3,5 % setelah pembedahan mayor abdomen dan dihubungkan dengan kematian sekitar 10 - 45%. Wound dehiscence merupakan komplikasi yang disebabkan oleh berbagai faktor. Rotterdam score dapat digunakan untuk menilai abdominal wound dehiscence karena memiliki nilai sfesifitas dan sensitifitas yang tinggi. Tujuan penelitian ini adalah untuk mengetahui gambaran dan karakteristik pasien wound dehiscence menurut variabel Rotterdam di ruang perawatan bedah RSUD Kota Bandung. Desain penelitian ini adalah deskriptif kuantitatif dengan pendekatan retrospektif. Data dikumpulkan dari rekam medis pasien dengan abdominal wound dehiscence periode januari 2014 sampai Desember 2014. Perhitungan data menggunakan rumus persentase. Pada hasil penelitian didapatkan 36 kasus abdominal wound dehiscence, 21 berjenis kelamin laki-laki (58%) dan 15 perempuan (42%). Berdasarkan kategori umur, yang terbanyak mengalami abdominal wound dehiscence adalah kelompok usia 50 – 69 tahun yaitu 17 pasien (47%), 24 Pasien (67 %) kasus emergensi. Berdasarkan penyakit penyerta, 6 pasien (17%) mengalami penyakit paru kronis, 2 pasien (6%) jaundice, 27 pasien (75%) anemia, dan 12 pasien (33%) dengan batuk pasca operasi. Berdasarkan tipe operasi didapatkan 3 pasien (8%) dengan pasca operasi gaster, 9 pasien (25%) pasca operasi usus halus, 18 pasien (50%) pasca operasi usus besar, serta 29 pasien (81%) mengalami infeksi luka operasi. Berdasarkan hasil penelitian, penderita dengan abdominal wound dehiscence terbanyak berasal dari kelompok umur 50 – 69 tahun, dengan penyakit penyerta terbanyak adalah anemia dan tipe operasi pasca operasi usus besar
Kata Kunci: Wound dehiscence, variabel Rotterdam.
ABSTRACT
Wound dehiscence is one of the most serious postoperative complications with high mortality and morbidity, 3 – 35%. The incidence wound dehiscence in the world is reported as 0,4% - 3,5% after major abdominal surgery, and 10% - 45% is associated with death. Wound dehiscence is complicated cases related to many factors, and Rotterdam risk score was used to rate abdominal wound dehiscence because its had a high specificity and sensitivity values. This research was conducted to describe patient characteristics with abdominal wound dehiscence using Rotterdam variable risk score at RSUD Kota Bandung. The methods was used a descriptive quantitative. A retrospective analysis was performed using the medical records of patient with abdominal wound dehiscence between January 2014 and December 2014 and had involved 36 cases. Data was analyzed by percentage. The result show that 36 patients developed wound dehiscence, 58% of them were male. From age category, the most incidence in 50 – 69 years old group (47%). The datas found 24 patients (67%) was emergency surgery, 6 patients (17%) with chronic obstructive pulmonary diseases, 2 patient (6%) jaundice, 27 patients (75%) anemia, 12 patients (33%) had cough. Based on Type of surgery, 3 patients (8%) had gaster and duodenum surgery, 9 patients (25%) had small bowel wurgery, 18 (50%) patients had large bowel surgery and 29 patients (81%) had wound infection. conclusion,the most patient abdominal wound dehiscence were in 50 – 69 years old group, with anemia, emergency surgery, and post large bowel surgery.
Keywords: wound dehiscence, variables of the Rotterdam score
Teks Lengkap:
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Ali, M., Saeeda., Israr, M., Hafiz., & Ullah, H.M. (2014). Frequency of abdominal wound dehiscence and role of wound infection as a major causative factor. Park J Surg, 30(1), 4-8.
Doherty, G.M., & Way, L.W. (2006). Postoperative complications. Current surgical diagnosis & treatment (12th ed). New York : Lange medical Books/McGraw Hill.
Hitesh, K., Pratik, V., Nilesh, P., & Jovin, M. (2015). Factors affecting post-operative laparotomy wound coplications. International archives of Integrated Medicine, 2(1), 71-74.
Johnson,C.M. (2009). Development of abdominal wound dehiscence after a colectomy : a nursing challenge. MedSurg Nursing, 1-7.
Kemenkes RI. (2013). Standar pelayanan minimal rumah sakit. Jakarta : Kemenkes.
Kenig, J., Richter, P., Lasek, A., Zbierska, K., & Zurawska, S. (2014). The Efficacy of risk scores for predicting abdominal wound dehiscence : a case-controlled validation study. BioMed central, 14(65), 1-6.
Khorgami, Z., & Et.al. (2012). Prophylactic retention suture in midline laparotomy in high risk for wound dehiscence : a randomized controlled trial. Journal of Surgical Research, xxx, E1-E6.
Meena, K., et.al. (2013). A Prospective Study of Factors Influencing Wound Dehiscence after Midline Laparotomy. Surgical Science, 4, 354-358.
Potter, P.A., & Perry, A.G. (2006). Buku Ajar Fundamental Keperawatan. Jakarta : EGC.
Ramneesh, G., Sheerin, S., Surinder, S., Bir, S. (2014). A Prospective Study of Predictors for Post Laparotomy Abdominal Wound Dehiscence. Journal of Clinical and Diagnostic Research, 8(1), 80-83.
Ramshorst, G. H., Nieuwenhuizen., Hop, W.C.J., Arends, P., Boom, J., Jeekel, J., Lange, J.F. (2010). Abdominal Wound Dehiscence in Adults : Development and Validation of a Risk Model. World Journal Surgical, 34, 20-27. DOI 10.1007/s00268-009-0277-y.
Smeltzer, S.C., & Bare, B.G. (2010). Post operative nursing wound management. In Brunner & Suddart's Textbook of medical-surgical nursing (12th ed.). Philadelphia: J.B. Lippincott Company.
Sorensen, L. T., Hemmingsen, U., Kallehave, F., Jorgensen, P.W., Kjoergaard, J., Moller, L.N., & Jorgensen, T. (2005). Risk Factor for Tissue and Wound Complications in Gastrointestinal Surgery. Annals of Surgery, 241(4,). Doi: 10.1097/01
Wolfram, D., Tzakhonvand, A., & Kalzer, H.P. (2009). Hypertropic Scars and Keloids Review of Their Pathophysiology, Risk Factors, and Therapeutic Management. Dermatol Surg 35, 171-181.
Waqar, S., Malik, Z., Razzaq, A., Abdullah, M., Shaima, A., & Zahid, M. (2005). Frequency and risk factors for wound dehiscence/burst abdomen in midline laparotomies. Journal Ayub Medical College Abottabad, 17(4), 70-73.
DOI: https://doi.org/10.31311/.v4i2.862
Diterbitkan oleh:
Lembaga Penelitian & Pengabdian Masyarakat (LPPM) Universitas BSI Bandung
